| NPI | 1063781714 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 16259) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024169711) |
| Enumeration Date | 2011-12-27 |
| Last Update Date | 2015-04-20 |